80 per cent of cardiovascular disease deaths are occurring in low- and middle-income countries. However, international heart-health guidelines are primarily based on research from high-income countries. One-size cardio health recommendations don’t fit all!
Exercise and diet recommendations for cardio health: May work for wealthier
countries but can be totally non-sequitur for folks in less-well-off regions…
Vancouver very different from New Delhi
“The world extends beyond high-income countries when we think about universal recommendations like ’75 minutes of exercise each week’ or getting ‘five servings of fruit and vegetables every day’,” says Scott Lear, a health sciences professor at SFU, the lead author of a new review examining the impact of social, environmental, and policy factors on cardiovascular disease globally.
“There’s a stark contrast between a daily sidewalk stroll in Vancouver’s West End and walking to work in New Delhi, the world’s most polluted city, where many people cannot afford to drive and public transit is lacking.”
What they did
The review paper examined the causes behind the causes of CVD, using data from the ongoing collaborative Prospective Urban Rural Epidemiology (PURE) study. This study has been collecting data from high-, middle- and low-income countries since 2002, and now includes over 212,000 participants from 28 countries across five continents.
PURE study data is collected every three years and includes a core survey, physical measurements (such as height, weight, blood pressure, waist-hip circumference, and lung capacity), and additional questionnaires targeting specific research interests, including CVD.
What they found
In addition to physical activity environments, Lear’s review identified several other causes behind the causes of CVD worldwide, including nutrition, education, tobacco use, air pollution, climate change, social isolation and access to medication, treatment and health care.
Lear and his team were surprised to find that consumption of fruits and vegetables is lower in low-income countries because farmers can’t afford to eat their own produce.
“This is a real eye opener,” says Lear. “For many of these farmers, getting the recommended minimum of five servings of fruits and vegetables a day would eat up 50 per cent of their household income.”
The takeaway
No wonder the conventional’ recommendations for cardio health – formulated based on what works in Western urban environments – don’t work for the rest of the world.
The usual takeaway – that further research is needed – certainly does apply in this case…
My take
That’s all well and good. And common-sensical, too. But…
What kind of cardio-health exercise CAN one recommend to folks in dirty environments where they can’t control the smog or the weather? Or in food-rich environments where most farmers can’t afford to eat what they grow?
~ Maggie J.